Acute and Sustained Effects of Cognitive Emotion Regulation in Major Depression
Acute and Sustained Effects of Cognitive Emotion Regulation in Major Depression
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DOI：
10.1523/jneurosci.1856-10.2010
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发表时间：
2010-11-24
影响因子：
5.3
通讯作者：
Walter, Henrik
中科院分区：
文献类型：
--
作者：
Erk, Susanne;Mikschl, Alexandra;Walter, Henrik
情绪和情绪调节功能失调是重度抑郁症的一个关键组成部分，会导致持续的负面情绪。我们利用功能性 MRI (fMRI) 研究了重度抑郁症患者和健康对照者情绪调节的时间动态，测试主动情绪调节的急性和持续神经效应。中度抑郁症患者 (n = 17) 和从未抑郁的健康对照受试者 (n = 17) 在执行主动认知情绪调节任务并观看情绪激动的图片时接受了功能磁共振成像 (fMRI)。在 15 分钟后完成的第二项任务中，受试者在被动观看任务中受到相同的刺激。全脑分析和连接测量用于确定情绪调节对大脑激活和区域之间耦合的急性和持续影响。在群体层面上，患者能够下调负面情绪和相应的杏仁核激活，但这种能力随着症状严重程度的增加而下降。此外，只有健康对照受试者在延迟 15 分钟后杏仁核表现出持续的调节作用，而抑郁症患者则没有。最后，患者在主动调节过程中表现出前额叶激活减少和前额边缘耦合减少。尽管药物治疗抑郁症患者的情绪调节能力似乎根据症状严重程度得以保留，但效果并不持久。相关分析提供的证据表明，这种持续调节效应的减弱可能与调节过程中前额叶激活的减少有关。
Dysfunctional regulation of mood and emotion is a key component of major depressive disorder and leads to sustained negative feelings. Using functional MRI (fMRI), we investigated the temporal dynamics of emotion regulation in patients with major depressive disorder and in healthy controls, testing for acute and sustained neural effects of active emotion regulation. Moderately depressed individuals (n = 17) and never-depressed healthy control subjects (n = 17) underwent fMRI during performance of an active cognitive emotion regulation task while viewing emotionally arousing pictures. In a second task, completed 15 min later, subjects were presented with the same stimuli in a passive viewing task. Whole-brain analyses and connectivity measures were used to determine acute and sustained effects of emotion regulation on brain activation and coupling between regions. On the group level, patients were able to downregulate negative emotions and corresponding amygdala activation, but this ability decreased with increasing symptom severity. Moreover, only healthy control subjects showed a sustained regulation effect in the amygdala after a 15 min delay, whereas depressed patients did not. Finally, patients exhibited diminished prefrontal activation and reduced prefrontolimbic coupling during active regulation. Although emotion regulation capacity in medicated depressive patients appears to be preserved depending on symptom severity, the effect is not sustained. Correlational analyses provide evidence that this diminished sustained-regulation effect might be related to reduced prefrontal activation during regulation.